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Form CMS-2746-U2 Esrd Death Notification - End Stage Renal Disease Medical Information System
What Is Form CMS-2746-U2?
This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services on October 1, 2018 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form CMS-2746-U2?
A: Form CMS-2746-U2 is a notification form for reporting the death of a patient with End Stage Renal Disease (ESRD).
Q: What is ESRD?
A: End Stage Renal Disease (ESRD) is the final stage of chronic kidney disease, where the kidneys have permanently stopped working.
Q: Who uses Form CMS-2746-U2?
A: Healthcare providers, such as dialysis facilities or hospitals, use this form to report the death of a patient with ESRD.
Q: What information is required on Form CMS-2746-U2?
A: The form requires information about the deceased patient, such as their name, social security number, date of birth, date of death, and the cause of death.
Q: Is Form CMS-2746-U2 mandatory?
A: Yes, healthcare providers are required to submit this form within 7 days of the patient's death.
Q: Are there any penalties for not reporting ESRD deaths?
A: Failure to report ESRD deaths in a timely manner may result in penalties, including fines or sanctions.
Q: Can family members or caregivers submit Form CMS-2746-U2?
A: No, only healthcare providers are authorized to submit Form CMS-2746-U2 to report ESRD deaths.
Form Details:
- Released on October 1, 2018;
- The latest available edition released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CMS-2746-U2 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.
Download Form CMS-2746-U2 Esrd Death Notification - End Stage Renal Disease Medical Information System
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